Login to Access Video or Poster Abstract: MP32-18
Sources of Funding: none

Introduction

Several websites present estimated complication rates for individual surgeons in both the United States and Great Britain. It remains unclear how the general population may interpret these complication rates and how these sites may influence the willingness to pay out-of-pocket expenses for out-of-network surgeons.

Methods

We invited attendees of the 2016 Minnesota State Fair who met entry criteria, i.e. adults >18 years old, English speakers who were able to use a tablet computer, to complete our survey. Participants were presented with various screen shots from online surgeon rating websites. Participants were then asked to interpret these graphics and report complication rates or estimate the risk of complications in future operations. Some graphics displayed complications rates for one surgeon alone, while others compared/ranked multiple surgeons side-by-side. Participants were then asked to make hypothetical health care decisions, including willingness to pay out-of-pocket expenses, based on their interpretation of the graphics.

Results

392 participants completed the survey from a broad geographic distribution from the upper Midwest (179 unique zip codes). Median age was 49 (Interquartile range 28-61), the female:male ratio was 3:2, 57% had completed a college or graduate degree and 85% were Caucasian vs. 15% ethnic minorities. When respondents were asked to compare/rank multiple surgeons, a large subset of respondents (n=136, 35%) drastically overestimated complication rates for some surgeons by 10 fold or more and were classified as misinterpreters. Misinterpreters were more likely to be willing to pay out of pocket expenses for a perceived &[prime]better surgeon&[prime] (odds ratio 3.4 95% CI 2.1-5.4), and were willing on average to pay $6101 for a 1 in 252 chance of lowering their risk of a postoperative complication. Misinterpreters were less likely to have graduated from college 45.6% vs. 62.5% who more accurately interpreted the data (p=0.0013).

Conclusions

Online surgeon rating websites that compare surgeons are often misinterpreted, particularly by those who did not graduate from college. Misinterpretation of the data may lead to patient harm by compelling patients to pay thousands of dollars of out-of-pocket expenses for an exceedingly low probability of benefit.

Funding

none